... costs, assessments and any other liability or assessment required or imposed on ... this agreement. When there is releaseof Surety approved by the ... .
11.
12.
The effective date of this Bond shall be ________________________________________________________. ...
State: Kansas Category: Workers Compensation

... WORKERS' COMPENSATION COVERAGE FOR OUT-OF-STATE INJURY
WHEREAS, , (SSN ) hereinafter ... employer a full and complete releaseof such injury or death ... employer from any and all liability arising from or growing out ... or given under the laws of any other state. IT IS ...
State: Nevada Category: Workers Compensation

... for litigation costs in the total amount of $ _____________ . _____ . 18. Miscellaneous provisions, if ... this agreement is a compromise and releaseof a workers' compensation claim, and is not considered an admission ofliability by employer and/or insurer ...
State: Pennsylvania Category: Workers Compensation

... existing and potential liabilities includes liability for temporary and permanent compensation ... the Surety. The date of the releaseof the Surety shall ... _____________________________________________ Address and Telephone Number of Surety
Please attach to this ...
State: Arizona Category: Workers Compensation

... injury(ies), including any and all liabilityof the employer(s) and the ... . The parties have considered the releaseof these benefits in arriving at ... misconduct discrimination (Labor Code §132a) statute of limitations future medical treatment other permanent ...
State: California Category: Workers Compensation